Parenthood changes couples' relationships across multiple domains, generally decreasing relationship quality, sexual satisfaction, and sexual frequency. Emerging research suggests that gay couples who are parenting might experience similar challenges. However, such changes might have even more profound implications for gay couples' health, and in particular their HIV risk, given the somewhat different ways in which they negotiate and tolerate sexual behaviors with outside partners. We aimed to examine these issues in a qualitative analysis of interviews from 48 gay male couples who were actively parenting children. Findings suggest that parenthood increases men's commitment to their primary relationship while simultaneously decreasing time and energy for relationship maintenance, and generally decreasing sexual satisfaction. These challenges alone did not generally result in greater infidelity or HIV risk, as most men reported successfully coping with such changes through a combination of acceptance and revaluing what is important in their relationships. Additionally, couples reported negotiating agreements regarding sex with outside partners that closely resemble those documented in studies of gay couples who are not parents. Men reported that parenthood typically decreased their opportunities to engage in sex with outside partners, but also posed barriers to talking about these behaviors with their partners and healthcare providers. HIV-related sexual risk behavior was relatively rare, but nevertheless present in some men. Providers should assess sexual function as a regular part of their work with gay couples who parent, and facilitate opportunities for men to discuss their sexual agreements both with their primary partners and with relevant healthcare providers.

The Multiphasic Sex Inventory (MSI; Nichols & Molinder, 1984) is a self-report measure frequently used in the assessment of sex offenders. Scores on the MSI are often used to assess levels of pedophilic interest. However, the question of whether men with pedophilia represent a unique group distinguished by their sexual interests, or whether they are high-scorers on a continuum of sexual interest in children among men who sexually offend against children remains unanswered. Because no existing evidence points conclusively to pedophilia having either a categorical or continuous latent structure, it is unresolved whether MSI scores should be treated as a continuous measure of severity or whether a cut score should be used to categorize individuals as members of a pedophilic taxon. In the present study, the authors used 3 taxometric procedures to analyze the latent structure of pedophilic interest in a sample of 371 convicted child sex offenders. The results converged to indicate that pedophilic interest (as measured by the MSI) is dimensional. The implications of these findings for the assessment of pedophilic interest are discussed.

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Adolescents who have sexually offended have unique treatment needs. For mental health professionals to adequately address these unique needs, further research is necessary. To that end, we explored the assessment of sexual interest (which may play an integral role in understanding potential for sexual reoffending) in a sample of 103 male adolescents who have sexually offended. We compared results from a physiological assessment (MONARCH 21 penile plethysmography [PPG]) and an actuarial assessment (Screening Scale for Pedophilic Interest [SSPI]), plus data from an unobstrusive assessment (Affinity, a viewing time measure) in a smaller subsample of 16 male adolescents. One finding that has particular relevance for clinical assessment is that the SSPI may have limited utility with adolescents. We also found evidence for some overlap between data from PPG and viewing time assessments, although whether or not PPG data are ipsatized may affect relationships with other assessment modalities.

A "unifying" approach to psychotherapy integration (Magnavita & Anchin, 2014) uses a metatheoretical framework to delineate mechanisms of psychopathology and change that cut across traditional theoretical orientations. Interpersonal Reconstructive Therapy (IRT; Benjamin, 2006, in press) is 1 such approach to treatment. In IRT, therapists view clinical symptoms and problems as natural consequences of maladaptive interpersonal patterns related to safety and threat that patients have learned and internalized in the context of close attachment relationships. Therapists may use interventions from any tradition so long as use is consistent with the individual patient's case formulation and underlying treatment principles. Prior work has suggested that adherence to IRT principles, particularly a focus on internalized attachments, has strong links to retention and outcome (Critchfield et al., 2011). In the present work, 19 outpatient IRT sessions were sampled from a research archive of therapies conducted with complex cases identified as comorbid, often rehospitalized, dysfunctional, and suicidal (CORDS). Included were 9 sessions showing high adherence to IRT principles and 10 contrasting low adherence sessions. Trained raters applied the Comparative Psychotherapy Process Scale (CPPS; Hilsenroth, Blagys, Ackerman, Bonge, & Blais, 2005). As expected, adherent IRT sessions contained both psychodynamic-interpersonal and cognitivebehavioral techniques in ways that reflected integrative theory. Less expected was that rater reliability in identifying standard techniques varied systematically as a function of IRT adherence. This last finding has broad implications for psychotherapy integration research, especially with principles-based, unified models.